Sigmoid volvulus adults

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Sigmoid volvulus occurs when the last part of the colon twists on itself, causing obstruction and compromising the blood supply to the colon. The sigmoid colon is an S-shaped part of the colon that is in the left lower side of the abdomen, above the rectum. With age, this part of the colon or its attachments to the abdominal wall stretch out, allowing it to twist on itself, similar to the twisting of a long balloon, resulting in a volvulus.

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Coffee bean sign, whirpool sign with free fluid in the peritoneal cavity. At the time of surgery, gangrenous sigmoid colon was noted. Resection of sigmoid colon with ostomy was done and initial pathology showed ganglion cells and the patient will have rectal biopsy to rule out Hirschsprung disease.

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Within a year, five young adult patients of Western origin, aged 19 to 24 years, were admitted because of sigmoidal volvulus. The chronic, intermittent course of the disease was manifested by abdominal pain, distention and chronic constipation, which lasted for periods ranging from four to 20 years before the condition was recognized and treated. Nonoperative reduction by proctoscopy, rectal tubes or therapeutic barium-enema was successful in treating four patients.

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The threat of impending intestinal catastrophes is always lurking in the Pediatric ED. It is contemplated with each patient with abdominal pain or vomiting. Recently, we also discussed adding Cecal Volvulus to this list of considerations. Not wanting to offend the other end of the large intestine, we should also mention another possible cause of intestinal obstruction — Sigmoid Volvulus in Children :.

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Volvulus is defined as the twisting of a loop of bowel on its mesentery and is one of the most common causes of intestinal obstruction. The sigmoid colonand less frequently, the cecumare the common sites of volvulus in adults. Volvulus in a neonate or infant almost always presents as a midgut volvulus secondary to intestinal malrotation.

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Recurrent sigmoid volvulus is a clinical entity characterized by recurrent episodes of partial or complete sigmoid volvulus. Although it is commonly seen in the elderly, it can be occasionally seen in younger patients. Patients with recurrent partial sigmoid volvulus are relatively asymptomatic or present with mild abdominal pain.

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Spotlight On Click here for issue 1, featuring our GI editor Dr. Raul Gonzalez.

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Key words: Chilaiditi's syndrome. Hepatodiaphragmatic interposition. Sigmoid volvulus.

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Sigmoid volvulus SV is an extremely rare cause of bowel obstruction in the newborn period. We report a neonatal case of SV misdiagnosed as small bowel volvulus. At laparotomy, the classical findings of SV were observed without gangrene. The operative procedure consisted of simple detorsion without sigmoidopexy.

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